Healthcare Provider Details

I. General information

NPI: 1093648800
Provider Name (Legal Business Name): GABRIELA MARTINEZ BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE STE 500
LONG BEACH CA
90806-2330
US

IV. Provider business mailing address

170 RACQUET CLUB DR
COMPTON CA
90220-3184
US

V. Phone/Fax

Practice location:
  • Phone: 562-304-1740
  • Fax:
Mailing address:
  • Phone: 323-542-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberRN95390975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: